The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jul 2012
Clinical TrialIntensive exercise after thermal injury improves physical, functional, and psychological outcomes.
Although exercise programs after burns are considered a standard of care, there is limited evidence for efficacy in adult patients. This study aimed to investigate the effects of an exercise program on physical, functional, and quality of life measures. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Jul 2012
Predicting outcomes after traumatic brain injury: the development and validation of prognostic models based on admission characteristics.
Early estimation of prognosis for the patient with traumatic brain injury is an important factor in making treatment decisions, resource allocation, classify patients, or communicating with family. We aimed to develop and validate practical prognostic models for mortality at 30 days and for 6 months unfavorable outcome after moderate and severe traumatic brain injury. ⋯ Our validated prognostic models have good performance and are generalizable to be used to predict outcome of new patients. We recommend the use of prognostic models to complement clinical decision making.
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J Trauma Acute Care Surg · Jul 2012
Does the size of the hemoperitoneum help to discriminate the bleeding source and guide therapeutic decisions in blunt trauma patients with pelvic ring fracture?
In blunt trauma patients with a hemoperitoneum and a pelvic injury, multiple sources of active bleeding may exist. The purpose of this study was to determine whether the size of the hemoperitoneum helps to establish the bleeding source and guide therapeutic decisions in patients with pelvic fractures. ⋯ In patients with pelvic fractures, hemoperitoneum does not mean peritoneal injury requiring hemostatic procedure. Semiquantitative analysis of the hemoperitoneum improves predictability of peritoneal hemorrhage than qualitative analysis of hemoperitoneum. However, there remains numerous false-positives even in presence of large hemoperitoneum associated with hypotension.
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J Trauma Acute Care Surg · Jul 2012
Validation of the pulse rate over pressure evaluation index as a detector of early occult hemorrhage: a prospective observational study.
The aim of this study was to validate a calculation of pulse rate (PR) divided by pulse pressure (pulse rate over pressure evaluation [ROPE] index) as a method of predicting early hemorrhagic compensation in healthy patients donating blood. The ROPE index calculations were compared with shock index (PR divided by systolic blood pressure) calculations for the same donors. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Jul 2012
Who is in danger? Impingement and penetration of the anterior cortex of the distal femur during intramedullary nailing of proximal femur fractures: preoperatively measurable risk factors.
Intramedullary nail (IMN) perforation through the cortex of the distal femur is a risk of intramedullary stabilization of proximal femur fractures. This study was performed to identify information that is available before operation that can pick out patients at risk for this complication. ⋯ Prognostic study, level III; therapeutic study, level IV.